Diabetic retinopathy, the most common diabetic eye disease, occurs when blood vessels in the retina change. Sometimes these vessels swell and leak fluid or even close off completely. In other cases, abnormal new blood vessels grow on the surface of the retina.
You can have diabetic retinopathy and not be aware of it, since the early stages of diabetic retinopathy often don't have symptoms.
As the disease progresses, diabetic retinopathy symptoms may include:
- Spots, dots or cobweb-like dark strings floating in your vision (called floaters)
- Blurred vision
- Vision that changes periodically from blurry to clear
- Blank or dark areas in your field of vision
- Poor night vision
- Colors appear washed out or different
- Vision loss
When blood sugar levels are too high for extended periods of time, it can damage capillaries that supply blood to the retina. Over time, these blood vessels begin to leak fluids and fats, causing edema. Eventually, these vessels can close off, called ischemia. Blocked blood vessels from ischemia can lead to the growth of new abnormal blood vessels on the retina (called neovascularization) which can damage the retina by causing wrinkling or retinal detachment. Neovascularization can even lead to glaucoma, damage to the optic nerve that carries images from your eye to your brain.
Diabetic Retinopathy Treatment
The best treatment for diabetic retinopathy is to prevent it. Strict control of your blood sugar will significantly reduce the long-term risk of vision loss. Treatment usually won't cure diabetic retinopathy nor does it usually restore normal vision, but it may slow the progression of vision loss. Without treatment, diabetic retinopathy progresses steadily from minimal to severe stages.
Laser surgery shrinks abnormal new vessels and reduces macular swelling. Laser surgery is usually performed in an office setting. For comfort during the procedure, an anesthetic eyedrop is often all that is necessary, although an anesthetic injection is sometimes given next to the eye. The patient sits at an instrument called a slit-lamp microscope. A contact lens is temporarily placed on the eye in order to focus the laser light on the retina with pinpoint accuracy.
Vitrectomy is a surgical procedure performed in a hospital or ambulatory surgery center operating room. It is often performed on an outpatient basis or with a short hospital stay. Either a local or general anesthetic may be used.
During vitrectomy surgery, an operating microscope and small surgical instruments are used to remove blood and scar tissue that accompany abnormal vessels in the eye. Removing the vitreous hemorrhage allows light rays to focus on the retina again. Laser surgery may be performed during vitrectomy surgery.
In some cases, medication may be used to help treat diabetic retinopathy. Steroid medication or anti-VEGF medication may be given.
After your pupil is dilated and your eye is numbed with anesthesia, the medication is injected into the vitreous. The medication reduces the swelling, leakage, and growth of unwanted blood vessel growth in the retina, and may improve how well you see.
Medication treatments may be given once or as a series of injections at regular intervals, usually around every four to six weeks or as determined by your doctor.